Kimberly Russom, NP in Union City, TN - Medicare Nurse Practitioner

Kimberly Russom, NP is a medicare enrolled "Nurse Practitioner - Family" in Union City, Tennessee. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fast Pace Medical Clinic Pllc, Hometown Urgent Care Of Dyersburg, Pllc and her current practice location is 1705 W Reelfoot Ave, Union City, Tennessee. You can reach out to her office (for appointments etc.) via phone at (731) 599-1102.

Kimberly Russom is licensed to practice in Tennessee (license number 31286) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1508506536.

Contact Information

	Kimberly Russom, NP
	1705 W Reelfoot Ave, Union City, TN 38261-5569
	(731) 599-1102
	(731) 599-1107

Map and Direction

Provider's Profile

Full Name	Kimberly Russom
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	1705 W Reelfoot Ave, Union City, Tennessee
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kimberly Russom graduated from nursing school in 2021

NPI Data:

NPI Number: 1508506536
Provider Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022

Medicare PECOS Information:

PECOS PAC ID: 6406242148
Enrollment ID: I20220406001999

Medical Identifiers

Medical identifiers for Kimberly Russom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508506536	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	31286 (Tennessee)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fast Pace Medical Clinic Pllc	5395881841	680
Hometown Urgent Care Of Dyersburg, Pllc	8820349202	9

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Russom allows following entities to bill medicare on her behalf.

Entity Name	Fast Pace Medical Clinic Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134452865 PECOS PAC ID: 5395881841 Enrollment ID: O20091014000112

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Russom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kimberly Russom, NP 1705 W Reelfoot Ave, Union City, TN 38261-5569 Ph: (731) 599-1102	Kimberly Russom, NP 1705 W Reelfoot Ave, Union City, TN 38261-5569 Ph: (731) 599-1102

Reviews and Comments

Nurse Practitioner Nurses in Union City, TN

Alicia Nicole Jernigan, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1020 E Reelfoot Ave Ste 201, Union City, TN 38261 Phone: 901-271-1000
Mrs. Tracey Kizer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 700 Sherrill St, Suite B, Union City, TN 38261 Phone: 731-884-3900 Fax: 731-884-3901
Amy K Harris, N.P Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1109 E Reelfoot Ave Ste F, Union City, TN 38261 Phone: 731-884-1412 Fax: 731-884-1720
Amanda Lee Keown, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1412 E Reelfoot Ave, Union City, TN 38261 Phone: 731-885-5131
Mrs. Kimberly Kaye Crowell, FNP-C Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1720 E Reelfoot Ave Ste 200, Union City, TN 38261 Phone: 731-507-0272 Fax: 731-507-0273
Jennifer Renee Vancleave, Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 702 Sherrill St, Union City, TN 38261 Phone: 731-885-8884 Fax: 731-599-2111
Mrs. Kristina Pollock, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1705 W Reelfoot Ave, Union City, TN 38261 Phone: 731-599-1102

Kimberly Russom, NP - Medicare Nurse Practitioner in Union City, TN